Estrace (Estradiol)

Estrace (estradiol) is an estrogen replacement therapy used to treat menopausal symptoms in women. The medication contains micronized estradiol, the same form of estrogen that women's ovaries naturally produce before menopause. By replacing the estrogen the body no longer makes, Estrace helps relieve common menopause symptoms like hot flashes and vaginal dryness. It's available as tablets in 0.5, 1, or 2 mg strengths, as well as a vaginal cream.

Directions

Estrace tablets should be taken by mouth at the same time each day, with or without food. For treating moderate to severe symptoms caused by menopause, the usual starting dosage ranges from 1 to 2 mg daily. Some people may require doses as low as 0.5 mg or as high as 6 mg per day.

A healthcare provider will determine the appropriate dose based on symptoms and treatment response. When used for conditions like female hypogonadism or primary ovarian failure, dosing may vary and involve cyclic administration, which means taking the medication for three weeks followed by one week off.

Those who use Estrace as part of a fertility treatment protocol should follow their clinic's specific instructions. It's important to use the lowest effective dose for the shortest duration needed to manage symptoms. Do not stop the medication abruptly without consulting a healthcare provider.

Ingredients

The active ingredient in Estrace is estradiol.

Cautions

Before using this medication, you may want to consult a healthcare provider about the following:

• Any existing health conditions
• Any allergies
• A list of all medications currently being taken
• Estrogen therapy like Estrace may increase the risk of serious cardiovascular events, including deep vein clots (DVT) and pulmonary embolism (PE). Stop Estrace and get emergency help if you have chest pain, sudden shortness of breath, coughing blood, one-sided leg swelling, sudden weakness, or trouble speaking.
• Stop before certain surgeries or long periods of bed rest. If possible, estrogens are usually stopped 4 to 6 weeks before surgery that increases clot risk.
• Using estrogen alone in someone who still has a uterus may increase the risk of endometrial (uterine) cancer, especially with longer use or higher doses. Report any unusual vaginal bleeding right away.
• Breast cancer risk may increase with long-term use. Estrogen (especially when combined with a progestin) has been linked to a higher risk of breast cancer in some studies. Keep up with routine breast exams and mammograms based on your age and risk factors.
• In studies of women age 65 and older, estrogen plus progestin was linked to a higher risk of probable dementia; it’s not clear if this applies to estrogen-only therapy.
• Gallbladder problems can happen. Estrogens have been linked to a higher risk of gallbladder disease that may require surgery.
• Vision changes are an emergency. Rarely, blood clots in the eye have been reported; stop Estrace and get checked urgently for sudden vision loss, new double vision, bulging of the eye, or a sudden severe migraine-like headache.
• Certain health conditions need extra caution. Estrace can worsen issues like high triglycerides (which can trigger pancreatitis), liver problems, fluid retention, migraines, asthma, diabetes, epilepsy, or lupus.
• Estrogen can change thyroid hormone binding, so some people on thyroid replacement may need a dose adjustment and monitoring.
• Estrace should not be used during pregnancy, and it may reduce breast milk supply and pass into milk. Discuss potential risks and benefits if you’re nursing.
• Estrace 2 mg contains FD and C Yellow No. 5 (tartrazine), which can rarely trigger allergic-type reactions (including asthma), especially in people sensitive to aspirin.

Contraindications

Avoid taking or using this medication if any of the following apply:

• Unexplained abnormal vaginal or genital bleeding
• Known, suspected, or prior breast cancer (except in carefully selected patients treated for metastatic disease)
• Known or suspected cancers that depend on estrogen for growth
• Current or past deep vein thrombosis or pulmonary embolism
• Current or recent arterial blood clots, including stroke or heart attack
• Liver disease or impaired liver function
• Known allergy or sensitivity to estradiol or any component of the product, including FD and C Yellow No. 5 (tartrazine), which may cause allergic reactions—especially in people with aspirin sensitivity
• Known or suspected pregnancy (this medication is not indicated during pregnancy)

Side Effects

Common side effects of Estrace include:

• Headache
• Breast tenderness or pain
• Irregular vaginal bleeding or spotting
• Nausea or stomach bloating

These side effects are usually mild and may occur as your body adjusts to estrogen therapy. Some people may also notice abdominal cramps, vomiting, hair thinning, or fluid retention. Vaginal yeast infections and dark patches of skin on the face can also occur in some individuals.

More serious side effects are less common but possible. Estrogen medicines like Estrace may increase the risk of blood clots, stroke, heart attack, breast cancer, uterine cancer, and gallbladder disease. Warning signs include unusual vaginal bleeding, breast lumps, severe headaches, chest pain, shortness of breath, leg pain, vision changes, or dizziness.